Knocking on the Doors of Perception: the role of psilocybin in substance use disorder treatment

Introduction Substance use disorders(SUDs) are a major health concern and current treatment interventions have proven only limited success. Despite increasing effectiveness, still about 50–60% relapse within 6–12 months after treatment [Cornelius et al., Addict Behav. 2003;28 381-386]. SUDs are def...

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Main Authors: R. Sousa, L. Costa, J. Brás, R. Vaz, J. Martins, J. Abreu, E. Almeida, N. Castro, R. Andrade, N. Cunha
Format: Article
Language:English
Published: Cambridge University Press 2023-03-01
Series:European Psychiatry
Online Access:https://www.cambridge.org/core/product/identifier/S0924933823006132/type/journal_article
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author R. Sousa
L. Costa
J. Brás
R. Vaz
J. Martins
J. Abreu
E. Almeida
N. Castro
R. Andrade
N. Cunha
author_facet R. Sousa
L. Costa
J. Brás
R. Vaz
J. Martins
J. Abreu
E. Almeida
N. Castro
R. Andrade
N. Cunha
author_sort R. Sousa
collection DOAJ
description Introduction Substance use disorders(SUDs) are a major health concern and current treatment interventions have proven only limited success. Despite increasing effectiveness, still about 50–60% relapse within 6–12 months after treatment [Cornelius et al., Addict Behav. 2003;28 381-386]. SUDs are defined as chronic disorders of brain reward system, motivation, and memory processes that have gone awry. Medication reducing craving and substance use is mainly available for alcohol dependence and to a lesser extent for other substances. Hallucinogens may represent a group of agents with potential anti-craving properties subsequently reducing substance use in SUD patients. For instance, lysergic acid diethylamide(LSD) and psilocybin have previously been shown to effectively alleviate symptoms of alcohol and nicotine dependence. Objectives New treatments preferably focusing on reducing craving and subsequent substance use are therefore urgently needed. The hallucinogen psilocybin may provide a new treatment option for SUD patients, given the beneficial results observed in recent studies Methods Systematic revision of literature. Results In the 1950s, a group of drugs with potential to alter consciousness were discovered (hallucinogens). Several studies suggested their anti-SUD potential, improving self-acceptance and interpersonal relationships, reducing craving and alcohol use. As a result of its recreational popularity during the 1960s, they were banned in 1967, greatly hampering scientific research in this field. Recently, psilocybin, an hallucinogenic substance in psilocybin-containing mushrooms has gained popularity in neuropsychological research, showing to increase trait openness, cognitive and behavioral flexibility, and ratings of positive attitude, mood, social effects, and behavior and even reported persistent positive changes in attitude and behavior. These findings might suggest a valuable compound for the treatment of psychiatric conditions with several additional studies providing supportive evidence for the therapeutic potential of psilocybin for SUD treatment and relapse prevention. Conclusions With the reported limited amount of side effects and potential beneficial effects of psilocybin in SUD, there are valid reasons to further investigate the therapeutic efficacy and safety of psilocybin as a potential SUD treatment. On the one hand, psilocybin may exert its anti-addictive properties by beneficial effects on negative emotional states and stress. On the other hand, psilocybin may improve cognitive inflexibility and compulsivity. Research on the efficacy of psilocybin on SUD is still limited to a handful of published studies to date. As a result, many important questions related to the use of psilocybin as a complement to current treatment of SUD and its working mechanisms remain unanswered. Before psilocybin can be implemented as a treatment option for SUD, more extensive research is needed. Disclosure of Interest None Declared
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spelling doaj.art-0af73bb0c8c9473eae49d396f6b05c8f2023-11-17T05:08:30ZengCambridge University PressEuropean Psychiatry0924-93381778-35852023-03-0166S270S27010.1192/j.eurpsy.2023.613Knocking on the Doors of Perception: the role of psilocybin in substance use disorder treatmentR. Sousa0L. Costa1J. Brás2R. Vaz3J. Martins4J. Abreu5E. Almeida6N. Castro7R. Andrade8N. Cunha91Departamento de Psiquiatria e Saúde Mental, Centro Hospitalar Tondela-Viseu 2Centro de Respostas Integradas Viseu, Divisão de Intervenção em Comportamentos Aditivos e Dependências, ARS Centro, Viseu, Portugal1Departamento de Psiquiatria e Saúde Mental, Centro Hospitalar Tondela-Viseu1Departamento de Psiquiatria e Saúde Mental, Centro Hospitalar Tondela-Viseu1Departamento de Psiquiatria e Saúde Mental, Centro Hospitalar Tondela-Viseu1Departamento de Psiquiatria e Saúde Mental, Centro Hospitalar Tondela-Viseu1Departamento de Psiquiatria e Saúde Mental, Centro Hospitalar Tondela-Viseu1Departamento de Psiquiatria e Saúde Mental, Centro Hospitalar Tondela-Viseu1Departamento de Psiquiatria e Saúde Mental, Centro Hospitalar Tondela-Viseu1Departamento de Psiquiatria e Saúde Mental, Centro Hospitalar Tondela-Viseu1Departamento de Psiquiatria e Saúde Mental, Centro Hospitalar Tondela-Viseu Introduction Substance use disorders(SUDs) are a major health concern and current treatment interventions have proven only limited success. Despite increasing effectiveness, still about 50–60% relapse within 6–12 months after treatment [Cornelius et al., Addict Behav. 2003;28 381-386]. SUDs are defined as chronic disorders of brain reward system, motivation, and memory processes that have gone awry. Medication reducing craving and substance use is mainly available for alcohol dependence and to a lesser extent for other substances. Hallucinogens may represent a group of agents with potential anti-craving properties subsequently reducing substance use in SUD patients. For instance, lysergic acid diethylamide(LSD) and psilocybin have previously been shown to effectively alleviate symptoms of alcohol and nicotine dependence. Objectives New treatments preferably focusing on reducing craving and subsequent substance use are therefore urgently needed. The hallucinogen psilocybin may provide a new treatment option for SUD patients, given the beneficial results observed in recent studies Methods Systematic revision of literature. Results In the 1950s, a group of drugs with potential to alter consciousness were discovered (hallucinogens). Several studies suggested their anti-SUD potential, improving self-acceptance and interpersonal relationships, reducing craving and alcohol use. As a result of its recreational popularity during the 1960s, they were banned in 1967, greatly hampering scientific research in this field. Recently, psilocybin, an hallucinogenic substance in psilocybin-containing mushrooms has gained popularity in neuropsychological research, showing to increase trait openness, cognitive and behavioral flexibility, and ratings of positive attitude, mood, social effects, and behavior and even reported persistent positive changes in attitude and behavior. These findings might suggest a valuable compound for the treatment of psychiatric conditions with several additional studies providing supportive evidence for the therapeutic potential of psilocybin for SUD treatment and relapse prevention. Conclusions With the reported limited amount of side effects and potential beneficial effects of psilocybin in SUD, there are valid reasons to further investigate the therapeutic efficacy and safety of psilocybin as a potential SUD treatment. On the one hand, psilocybin may exert its anti-addictive properties by beneficial effects on negative emotional states and stress. On the other hand, psilocybin may improve cognitive inflexibility and compulsivity. Research on the efficacy of psilocybin on SUD is still limited to a handful of published studies to date. As a result, many important questions related to the use of psilocybin as a complement to current treatment of SUD and its working mechanisms remain unanswered. Before psilocybin can be implemented as a treatment option for SUD, more extensive research is needed. Disclosure of Interest None Declaredhttps://www.cambridge.org/core/product/identifier/S0924933823006132/type/journal_article
spellingShingle R. Sousa
L. Costa
J. Brás
R. Vaz
J. Martins
J. Abreu
E. Almeida
N. Castro
R. Andrade
N. Cunha
Knocking on the Doors of Perception: the role of psilocybin in substance use disorder treatment
European Psychiatry
title Knocking on the Doors of Perception: the role of psilocybin in substance use disorder treatment
title_full Knocking on the Doors of Perception: the role of psilocybin in substance use disorder treatment
title_fullStr Knocking on the Doors of Perception: the role of psilocybin in substance use disorder treatment
title_full_unstemmed Knocking on the Doors of Perception: the role of psilocybin in substance use disorder treatment
title_short Knocking on the Doors of Perception: the role of psilocybin in substance use disorder treatment
title_sort knocking on the doors of perception the role of psilocybin in substance use disorder treatment
url https://www.cambridge.org/core/product/identifier/S0924933823006132/type/journal_article
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